Does Diabetes Qualify for Disability? Diabetes Disability Accommodations From the SSA

For millions, diabetes isn’t just a diagnosis; it fundamentally changes daily life. Knowing if diabetes is a disability and how to get Social Security Disability for it is key if you are affected. This article will go over the qualifications for diabetes as a debilitating disability and walk you through the process for applying for disability benefits. Follow along and you’ll be able to navigate the process of qualifying and getting Social Security Disability.

Social Security Disability for Diabetes: Quick Facts

• You must have major health problems from diabetes to qualify for Social Security Disability.
• Diabetics do not generally qualify for disability unless symptoms are extreme, but both type 1 and type 2 diabetes can qualify depending on whether you have serious health problems and complications such as blindness.
• Medical records are key to proving how diabetes affects daily life and work ability.
• Types of benefits are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

What is Diabetes? Symptoms and Side Effects

Diabetes is a chronic condition that affects the body’s ability to regulate blood sugar levels. There are two types of diabetes: type 1 and type 2. Both can be serious if not managed. Common symptoms of diabetes are blurred vision, fatigue, increased hunger and thirst, increased urination, numbness and tingling in the hands and feet, weight loss, and sores that won’t heal. Unmanaged diabetes can lead to serious complications like eye problems, heart disease, kidney disease, and peripheral neuropathy.

Type 1 Diabetes

Type 1 diabetes is an absolute deficiency in insulin production, meaning the body can’t produce insulin on its own. This type of diabetes usually starts in childhood and requires lifetime treatment with daily insulin injections. It’s also known as juvenile diabetes or insulin-dependent diabetes mellitus (IDDM). Managing type 1 diabetes involves monitoring blood sugar levels, a strict diet, and regular exercise.

Type 2 Diabetes

Type 2 diabetes is when the body’s cells resist insulin, causing impaired glucose absorption and metabolism. This type is more common in adults and is often linked to a sedentary lifestyle. Treatment for type 2 diabetes involves lifestyle changes like increased exercise and a modified diet, along with medication and possibly insulin. It’s also known as adult-onset diabetes or non-insulin-dependent diabetes mellitus (NIDDM).

SSA Disability Criteria

The Social Security Administration (SSA) has specific rules to determine if you qualify for disability benefits. These rules apply to many medical conditions not just diabetes. To be eligible you must have a medical condition that prevents you from doing basic work activities for at least 12 months or will result in death. The SSA will evaluate each application based on the severity of the condition, medical records, and how it affects your ability to work.

The SSA will consider:

• Medical Records: Complete medical records that show your diagnosis, treatment, and response to treatment.
• Severity of Condition: The condition must severely impact your ability to do basic activities like walking, standing, lifting, sitting, or remembering.
• Duration of Impairment: The impairment must last or be expected to last at least 12 months or be terminal.
• Ability to Work: The SSA will determine if your condition prevents you from doing any work you’ve done in the past and if you can adjust to other work considering your age, education, and work experience.

Meeting these rules is key to getting disability benefits. Proper documentation and proof is necessary to support your claim and show the extent of your disability.

Is Diabetes a Disability According to the SSA?

The Social Security Administration (SSA) considers diabetes a disability if it prevents an individual from doing basic work activities, though it isn’t an independent listing in the SSA blue book. However, most cases of diabetes don’t qualify unless they have severe and persistent complications. For diabetes to be considered disabling by the SSA, you must not be able to perform Substantial Gainful Activity and earn a living to support yourself. Some possible symptoms that may qualify you for disability benefits include:

• Persistent Hyperglycemia: Chronic high blood sugar levels that cause serious complications like diabetic ketoacidosis (DKA) that require frequent hospitalizations.
• Hypoglycemia: Frequent low blood sugar episodes that cause seizures or unconsciousness despite following treatment.
• Neuropathy: Severe nerve damage that causes significant pain, numbness or weakness that limits mobility and ability to use hands.
• Retinopathy: Advanced diabetic eye disease that causes significant vision loss or blindness.
• Nephropathy: Severe kidney disease that requires dialysis.
• Cardiovascular Complications: Serious heart conditions like coronary artery disease or chronic heart failure caused by diabetes.
• Amputation: Loss of limbs due to poor circulation and non-healing wounds can impact jobs that require mobility or motor dexterity.
• Other Severe Complications: Conditions like diabetic foot ulcers or peripheral vascular disease that limit mobility and daily living.

To get any type of disability benefits, the SSA must see these complications documented in your medical records and that they persist despite treatment. The condition must significantly impact your ability to do daily activities and work-related activities. Proper and detailed medical records are key to proving that diabetes with its complications meets the SSA’s rules for a disability.

How Hard is it to Get Disability for Diabetes?

Getting disability for diabetes can be tough because most cases don’t meet the Social Security Administration’s (SSA) strict rules. While diabetes is a disabling condition, many people manage their symptoms well enough to continue working. Here’s why it’s hard to get disability for diabetes:

• High Initial Denial Rate: Up to 80% of first-time applications are denied. This is often because the symptoms aren’t severe enough to meet the SSA’s rules or the medical records aren’t sufficient.
• Severe and Persistent Symptoms: To qualify, diabetes must cause severe complications that prevent you from doing basic work activities. Conditions like diabetic ketoacidosis (DKA), chronic hyperglycemia, severe neuropathy or significant vision loss are required.
• Complete Medical Records: Detailed medical records are key to proving the severity and persistence of your symptoms. This includes records of hospitalizations, treatment regimens and impact on daily living.
• Ability to Work: The SSA will determine if you can do any work based on your age, education and work experience. If you can adjust to other work despite your diabetes, you may not qualify.
• Long Application and Appeal Process: The initial application process takes 3-5 months and if denied, the appeal process can take several more months or even years. Be persistent and prepare thoroughly.

Knowing this will help you prepare your application and gather evidence to increase your chances of approval.

Which Diabetes Symptoms Will Limit Your Ability to Work?

For diabetes to be considered a disability by the Social Security Administration (SSA), the symptoms must be severe enough to significantly impact your ability to work. Here are specific diabetes-related symptoms and complications that will limit your ability to do daily work activities:

• Diabetic Ketoacidosis (DKA): This serious complication occurs when the body produces high levels of blood acids (ketones). It requires frequent hospitalizations and intensive treatment and will disrupt your work life.
• Chronic Hyperglycemia: High blood sugar levels over time can cause various complications including nerve and blood vessel damage that affects mobility and ability to do manual tasks.
• Severe Neuropathy: Nerve damage causes intense pain, numbness, and weakness, especially in the hands and feet. This will limit your ability to walk, stand, or use your hands.
• Significant Vision Loss: Diabetic retinopathy and other eye problems can cause partial or total blindness making it hard to do tasks that require good vision.
• Hypoglycemia: Frequent low blood sugar episodes can cause seizures, loss of consciousness, and mental confusion and is a safety risk in many work environments.
• Kidney Disease: Diabetic nephropathy can progress to end-stage renal disease that requires dialysis which is time-consuming and physically draining.
• Amputations: Poor circulation and non-healing wounds can cause amputation of limbs that will severely limit mobility and physical capabilities.
• Cardiovascular Complications: Diabetes can exacerbate heart conditions like coronary artery disease and chronic heart failure that will reduce stamina and the ability to do physically demanding tasks.
• Mental Health Issues: Conditions like depression and anxiety that are common with chronic illnesses will further limit your ability to work consistently and effectively.

For these symptoms to support a disability claim you need comprehensive medical documentation. This includes detailed records of treatments, hospitalizations and how these symptoms impact daily life and work activities.

Other Medical Conditions & Comorbidities That Will Help You Get Disability for Diabetes

When applying for disability due to diabetes other medical conditions and comorbidities can help by showing the overall severity of your health issues. Cardiac arrhythmias caused by diabetes-related heart damage can severely impact physical stamina and increase the risk of heart-related incidents. Peripheral neuropathy that causes severe nerve damage in the limbs can cause chronic pain, numbness, and muscle weakness that will limit mobility and manual dexterity. Diabetic nephropathy or kidney disease caused by diabetes can progress to end-stage renal disease that requires dialysis and will severely impact overall health and energy levels.

Mental health conditions like depression and anxiety can be triggered by the chronic nature of diabetes and affect concentration, emotional stability, and ability to cope with stress. Diabetic retinopathy an advanced eye disease can cause vision loss making it hard to do tasks that require good vision. Intestinal necrosis (severe digestive system damage caused by diabetes) can cause chronic gastrointestinal issues and frequent hospitalizations. Cerebral edema. swelling in the brain caused by diabetes complications, can cause severe headaches, seizures, and cognitive impairment. Chronic high and low blood sugar episodes can cause serious health incidents like seizures, fainting, and confusion, which can be a safety risk in many work environments.

Medical Evidence Needed for Your Diabetes Disability Claim

For your diabetes disability claim to be approved the Social Security Administration (SSA) requires comprehensive and detailed medical evidence. This evidence must show the severity and duration of your diabetes and its complications and how these health issues impact your ability to work. Here’s what you need:

Medical Records

Accurate and thorough medical records are key. These should include:

• Detailed notes from your doctors that document your diagnosis, treatment plans, and response to treatment.
• Records of hospitalizations, emergency room visits, and any surgeries related to diabetes complications.
• Documentation of your blood sugar levels over time, especially high and low blood sugar episodes.
• Notes on any prescribed medications, including insulin and dosages.

Medical Evidence

The SSA looks for specific medical evidence to support your claim. This includes:

• A1C Test Results: High A1C levels (10% or higher) consistently show poorly controlled diabetes.
• Complications: Detailed records of severe complications like diabetic ketoacidosis (DKA), peripheral neuropathy, retinopathy, and nephropathy.
• Specialist Reports: Reports from endocrinologists and other specialists that can explain the severity and prognosis of your condition.

Evidence that Work Triggers Your Symptoms

You need to provide evidence that your work environment makes your diabetes symptoms worse. This includes:

• Statements from your employer or coworkers about how your condition affects your job performance.
• Medical opinions that link your work activities to your symptoms worsening.
• Records of any work accommodations tried and the results.

Other Conditions

If you have other health conditions that make your diabetes worse, documentation of these is key. This includes:

• Diagnoses of related conditions like heart disease, mental health conditions, or gastrointestinal issues.
• Evidence of how these conditions interact with your diabetes and further limit your ability to work.
• Treatment plans and responses for these other conditions.

Putting all this medical evidence together can really help your disability claim show the full effect of diabetes on your ability to work.

How to Apply for Diabetes Disability Benefits

Applying for disability benefits for diabetes is a multi-step process that requires preparation and documentation. Here’s how to apply for both SSI and SSDI:

Apply for Social Security Disability Insurance (SSDI) with Diabetes

Social Security Disability Insurance (SSDI) is based on your work history. To qualify you must have worked and paid Social Security taxes for at least five of the last ten years. First gather all your medical records including diagnoses, treatment plans, and evidence of diabetes-related complications. Make sure your work history is well documented. Then complete the application which can be done online, by phone, or in person at your local Social Security office. The application will ask for detailed information about your medical condition, work history, and daily activities. Submit the application with all relevant medical evidence and documentation of your work history. Being thorough can help avoid delays in processing.

Apply for Supplemental Security Income (SSI) with Diabetes

Supplemental Security Income (SSI) is a needs-based program for individuals with limited income and resources. Unlike SSDI, SSI does not require a work history. First, check your financial eligibility to see if you meet the income and resource limits for SSI. As of 2024, the maximum SSI payment is $943 per month. Gather all your medical records like you would for SSDI, including evidence of the severity of your diabetes. Complete the application online, by phone, or in person and provide detailed information about your financial situation, medical condition, and daily life. Submit the application with all necessary medical and financial documentation to support your claim.

Applying for disability can take three to five months for an initial decision. If denied you have the right to appeal which can add more time. Being thorough and accurate in your application can help you get approved.

Work with a Disability Lawyer to Get Approved

The disability process can be complicated. LegalQuestions connects you with top-rated local attorneys who practice disability law. Our network has helped over 1.7 million people, with over 500 law firms across the country.

Navigating the disability benefits process can be overwhelming. LegalQuestions connects you with top-rated local attorneys who specialize in disability cases. Our network has helped over 1.7 million people, offering support with over 500 law firms nationwide.

With 24/7 phone and chat support, you can get the legal assistance you need quickly. Don’t wait—reach out to LegalQuestions to connect with a lawyer who can help you get the benefits you deserve.